Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_298»

КАРТОЧКА-ЗАДАНИЕ НА ТЕМУ

«MEDICAL WRITING: CASE ABSTRACT_298»

Warm-up

·         What is a medical case report?

·         What parts does it include?

·         What is an abstract?

Read the abstract of the medical case report:

Atrial fibrillation associated with a thyroid stimulating hormone-secreting adenoma of the pituitary gland leading to a presentation of acute cardiac decompensation: A case report

Abstract

Introduction

Hyperthyroidism is a well established cause of atrial fibrillation (AF). Thyroid Stimulating Hormone-secreting pituitary tumours are rare causes of pituitary hyperthyroidism. Whilst pituitary causes of hyperthyroidism are much less common than primary thyroid pathology, establishing a clear aetiology is critical in minimising complications and providing appropriate treatment. Measuring Thyroid Stimulating Hormone (TSH) alone to screen for hyperthyroidism may be insufficient to appropriately evaluate the thyroid status in such cases.

Case presentation

A 63-year-old Caucasian man, previously fit and well, presented with a five-day history of shortness of breath associated with wheeze and dry cough. He denied symptoms of hyperthyroidism and his family, social and past history were unremarkable. Initial investigation was in keeping with a diagnosis of atrial fibrillation (AF) with fast ventricular response leading to cardiac decompensation.

TSH 6.2 (Normal Range = 0.40 – 4.00 mU/L), Free T3 of 12.5 (4.00 – 6.8 pmol/L) and Free T4 51(10–30 pmol/L). Heterophilic antibodies were ruled out. Testosterone was elevated at 43.10 (Normal range: 10.00 – 31.00 nmol/L) with an elevated FSH, 18.1 (1.0–7.0 U/L) and elevated LH, 12.4 (1.0–8.0 U/L). Growth Hormone, IGF-1 and prolactin were normal. MRI showed a 2.4 cm pituitary macroadenoma. Visual field tests showed a right inferotemporal defect.

While awaiting neurosurgical removal of the tumour, the patient was commenced on antithyroid medication (carbimazole) and maintained on this until successful trans-sphenoidal excision of the macroadenoma had been performed. AF persisted post-operatively, but was electrically cardioverted subsequently and he remains in sinus rhythm at twelve months follow-up off all treatment.

Conclusion

This case reiterates the need to evaluate thyroid function in all patients presenting with atrial fibrillation. TSH-secreting pituitary adenomas must be considered when evaluating the cause of hyperthyroidism. Early diagnosis and treatment of such adenomas is critical in reducing neurological and endocrine complications.

Find in the abstract:

·         Background

·         Why is it important

·         Needs to be reported

Answer the questions:

1.       Is this the first report of this kind in the literature?

2.       What are brief details of what the patient(s) presented with?

3.       What the reader should learn from the case report?

4.       What the clinical impact will be?

5.       Is it an original case report of interest to a particular clinical specialty of medicine?

6.       Will it have a broader clinical impact across medicine?

7.       Are any teaching points identified?

Follow-up

·         Why abstract is the most important part for case published in electronic databases?

·         What are basics of abstract writing?